Drug Treatment of HIV

Question 1

How do people get HIV?

Answer 1

Unprotected vaginal sex, unprotected anal sex, blood transfusions, oral sex, injecting needles, mother to child transmission

Question 2

What factors determine the clinical stage of HIV?

Answer 2

CD4 count and time

Question 3

What are the clinical stages of HIV?

Answer 3

Primary infection, CDC A (asymptomatic), CDC B (symptomatic), CDC C (AIDs defining)

Question 4

What conditions are associated with CDC B?

Answer 4

Oral candida, OHL, CIN-2/3, multidermatomal HZV, peripheral neuropathy, constitutional symptomsvand ITP

Question 5

What conditions are associated with CDC C? (AIDs)

Answer 5

Tb/MAI, cryptococcus, PCP, oesophageal candida, PML, CMV, KS/NHL, toxoplasma, cryptospporidia, recurrent bacterial pneumonia

Question 6

How do we delay progression of HIV?

Answer 6

Diagnose, regular monitoring of CD4 and viral load, prophylaxis to stop PCP, HSV and rarely CMV/TB/MAI and finally get patient on HAART/cART

Question 7

How many drugs are initially used to treat HIV?

Answer 7

3

Question 8

What are the 4 main types of drugs used?

Answer 8

Nucleotide reverse transcriptase inhibitors, non-nucleotide RTIs, boosted protease inhibitors and fusion inhibitors

Question 9

What are the 3 newer classes of drugs?

Answer 9

Intergrase inhibitor, CCR5 inhibitors and Depo preparations

Question 10

How do we know if the drugs are working?

Answer 10

Undetectable viral load, immune reconstitution, CD4 inc, reduced risk of OIs, return to a normal life, increased life span

Question 11

Reasons for treatment failure

Answer 11

Poor adherence, toxicity, wrong combination, poor preparation, reduced absorption (vol distribution, GI inflammation), drug interactions and acquired resistance